TO HAVE GARDASIL AND HAVE NOT

November 18, 2008

Although Merck's Human paillomavirus (HPV) vaccine Gardasil is currently approved only for women between the ages of nine and 26, several new studies suggest the vaccine could be beneficial for older women and even men. But should everyone who could potentially benefit from the vaccine be categorically encouraged to receive it -- especially considering Gardasil's high price tag, asks Elizabeth Wade, a research intern with the American Council on Science and Health?

For example:

A recent study used a mathematical model to show that vaccinating 45-year-old women in the United States with Gardasil could reduce their cases of cervical cancer by 55 percent (assuming near-impossible 100 percent vaccination rates).

But thanks to the widespread use of pap smears in this country, the risk of dying from cervical cancer is already 70 percent lower than it was in the mid-twentieth century.

And because Gardasil does not protect against all the HPV strains that cause cervical cancer, even women who get the vaccine should undergo annual pap smears.

While pap smears and HPV tests have dramatically cut an American woman's chance of dying from cervical cancer, the disease remains the leading cause of cancer deaths among women in a majority of developing countries -- who account for 85 percent of its yearly cases, notes Wade.

Making Gardasil available and affordable around the world -- especially in places where women don't have reliable access to quality health care (and where yearly pap smears, let alone effective treatments for late-stage cervical cancer, are virtually impossible to come by) -- is the most important public health initiative we can take regarding this potentially life-saving vaccine, says Wade.

Source: Elizabeth Wade, "Who Should Get Gardasil?" American Council on Science and Health, November 14, 2008.